Abstract
BackgroundGiven the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype “waist circumference for a given body mass index (WCBMI)”, a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WCBMI.Methods and FindingsWe analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WCBMI was defined as the residuals of waist circumference regressed on body mass index, and annual change in WCBMI (ΔWCBMI, cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and ΔWCBMI was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WCBMI, compared to those with lower ED and GI [1 kcal/g greater ED predicted a ΔWCBMI of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a ΔWCBMI of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher ΔWCBMI.ConclusionsResults of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WCBMI. Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake.
Highlights
There is a wealth of evidence indicating that waist circumference (WC) remains a significant predictor of chronic diseases such as type 2 diabetes, cardiovascular diseases, cancer, as well as total mortality after adjusting for body mass index (BMI) or fat mass [1,2,3,4,5,6,7,8]
Results of this study suggest that a diet with low glycemic index (GI) and energy density (ED) may prevent visceral adiposity, defined as the prospective changes in WC for a given BMI (WCBMI)
A diet with higher ED was significantly associated with a greater annual gain in WCBMI, in both men and women: 1 kcal/g increase in ED predicted 0.09 cm and 0.15 cm higher DWCBMI in men and women respectively
Summary
There is a wealth of evidence indicating that waist circumference (WC) remains a significant predictor of chronic diseases such as type 2 diabetes, cardiovascular diseases, cancer, as well as total mortality after adjusting for body mass index (BMI) or fat mass [1,2,3,4,5,6,7,8]. Given the widely recognized effects of WCBMI on health, the understanding of how diet can modulate changes in this phenotype is deemed necessary. The objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by the phenotype WCBMI, i.e. changes of WC that are independent of changes in BMI. Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype ‘‘waist circumference for a given body mass index (WCBMI)’’, a proxy measure of visceral adiposity, is deemed necessary.
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